Calcitonin Brand Names- Fortical | Miacalcin
What is Calcitonin
Calcitonin is a polypeptide hormone produced in the parafollicular (C) cells of the thyroid gland in humans; the hormone binds directly to receptors on the osteoclast surface, inhibiting bone resorption and decreases serum calcium.
Commercial preparations of salmon calcitonin are prepared synthetically or using recombinant DNA methods.
Salmon calcitonin is 40 to 50 times more potent and has a longer duration than human calcitonin; its structure differs from human calcitonin by 13 amino acid residues.
Calcitonin has been used in the treatment of Paget’s disease of the bone, either alone or with other agents for the management of hypercalcemia, and for postmenopausal osteoporosis.
Injectable calcitonin is used clinically in treatment protocols hypercalcemic emergencies to help produce a rapid decrease in serum calcium until more specific treatment of the underlying disease is instituted.
Injectable and intranasal calcitonin therapy prevents bone loss and increases bone density in the vertebral spine in postmenopausal women with osteoporosis; some studies have shown a reduction in future vertebral fracture with use.
Guidelines generally recommend against calcitonin for the treatment of osteoporosis; the efficacy of calcitonin in preventing non-vertebral fractures is not established, and the increase in bone mineral density is less than that reported for other agents (e.g., bisphosphonates).
Calcitonin may be considered for women who can not or will not take more effective agents; use within 5 years of menopause onset is not recommended as benefit/efficacy has not been observed in early menopause.
Calcitonin may reduce the pain of acute osteoporotic vertebral fractures and is sometimes used short-term for this purpose off-label, but there is no sufficient data that calcitonin is effective for chronic pain due to prior osteoporotic vertebral fractures.
The potential analgesic effect of calcitonin continues to be investigated for other types of bone fracture and for patients with bone metastases due to cancer.
For Paget’s disease, the use of injectable calcitonin leads to partial radiographic healing of lytic lesions, but most patients do not achieve normalization of bone turnover, and thus calcitonin has limited use versus newer, more effective agents (i.e., bisphosphonates).
The first salmon calcitonin injectable product was FDA-approved in 1975. A human calcitonin product approved in 1986 is no longer marketed.
Intranasal salmon calcitonin products were initially FDA-approved in 1995.
Oral calcitonin dosage forms have been investigated but trials have been discontinued due to lack of efficacy.
- bone pain
- Paget’s disease
- abdominal pain
- anaphylactic shock
- anaphylactoid reactions
- antibody formation
- appetite stimulation
- back pain
- blurred vision
- bundle-branch block
- hearing loss
- injection site reaction
- laryngeal edema
- muscle cramps
- myocardial infarction
- nasal congestion
- nasal dryness
- nasal irritation
- new primary malignancy
- ocular pain
- peripheral edema
- sinus tachycardia
- skin ulcer
- weight gain
- serum 25(OH)hydroxyvitamin D concentrations
- serum alkaline phosphatase
- serum calcium
- fish hypersensitivity
- nasal trauma
- new primary malignancy
- Calcium Acetate
- Calcium Carbonate
- Calcium Carbonate; Magnesium Hydroxide
- Calcium Carbonate; Risedronate
- Calcium Carbonate; Simethicone
- Calcium Chloride
- Calcium Gluconate
- Calcium; Vitamin D
- Hetastarch; Dextrose; Electrolytes
- Vitamin D analogs